We are collaborating researchers specializing in improving asthma care. We are implementing the CAP asthma improvement program for Navajo children and assessing its effectiveness. CAP will bring together schools, clinics, and community resources to improve asthma care for Navajo children in 3 Navajo Nation agencies: Tuba City, Chinle and Fort Defiance.
What is the burden of asthma in Navajo Nation children? Why is this needed?
Asthma is more common in Navajo children (13.0% versus 8.6% in U.S. children). Severe asthma attacks in Navajo children are common. Asthma care for Navajo children has some strengths and areas for improvement. This program is needed because of high rates of childhood asthma on the Navajo Nation. In our pilot study in Chinle, we found that 37% of children had been or oral corticosteroids for a severe exacerbation in the past year, few had a lung function assessment, and only 27% had asthma action plans. In our interviews with families of children with asthma in Tuba City, parents frequently said that schools are often not equipped to respond to their child’s asthma symptoms at school.
What is the format of the program?
School Program: First, we will implement the Open Airways For Schools® program from the American Lung Association. Open Airways For Schools is the most widely recognized asthma management program for children and a proven, effective way to improve asthma self-management skills, decrease asthma emergencies and raise asthma awareness. The program teaches children with asthma how to detect the warning signs of an asthma attack, avoid their triggers and make decisions about their health. Second, we will provide Asthma 101™ training to school staff to help them better understand asthma and what to do if a child has asthma symptoms at school. Finally, we will work with health care providers to asthma medication to schools so children with asthma will always have access to quick relief medication.
Health Care Provider Training: We will work with clinic doctors and staff in Navajo Nation to improve assessment, diagnosis and management of asthma. This includes providing the proper tools for assessment, such as spirometry lung function, as well as training to interpret spirometric data. Training will be tailored to suit the needs of each clinic, and generally will involve the following:
- a 90-minute online training in best practices;
- a half-day, in-person training with hands-on spirometry; and
- a follow-up in clinics by our nurse educators, who will help troubleshoot implementation problems and barriers.
Who are the researchers?
Our team brings together physicians, behavioral health experts, social scientists, pharmacists, and respiratory therapists from the University of Arizona, National Jewish Health (a respiratory hospital in Denver, CO), Colorado Children’s Hospital, the University of Michigan, and the University of Utah. We also employ Navajo research staff who live on the reservation. Our study office is in Chinle, AZ.
Who is funding the study?
We are funded by the National Heart, Lung, and Blood Institute, a branch of the National Institutes of Health.